Effects of Manual Versus Instrumental Spinal Manipulation
on Blood Flow of the Vertebral and Internal Carotid
Arteries in Participants With Chronic Nonspecific
Neck Pain: A Single-Blind, Randomized StudyThis section is compiled by Frank M. Painter, D.C.
Send all comments or additions to: Frankp@chiro.org
FROM: J Chiropractic Medicine 2023 (Mar); 22 (1): 1–10 ~ FULL TEXT
OPEN ACCESS Burcu Kocabey, Dilber Karagozoglu Coskunsu, PhD, Koray Guven, Mustafa H. Agaoglu, DC, Selvi Yuce
Bahcesehir University Institute of Health Sciences,
Istanbul, Turkey
FROM: J Chiropractic Medicine 2007Objective The aim of this study was to compare the hemodynamic effects of manual spinal manipulation (MSM) and instrumental spinal manipulation (ISM) on the vertebral artery (VA) and internal carotid artery (ICA) in participants with chronic nonspecific neck pain (NNP).
Methods Thirty volunteers aged 20 to 40 years old with NNP over 3 months duration were included. Participants were randomly divided into the following 2 groups: (1) MSM group (n = 15) and (2) ISM group (n = 15). Ipsilateral (intervention side) and contralateral (opposite side of intervention) VAs and ICAs were evaluated using spectral color Doppler ultrasound before and immediately after manipulation. Measurements were recorded by visualizing the ICA carotid sinus (C4 level) and the VA at the V3 segment (C1-C2 level). The blood flow parameters of peak systolic velocity (PSV), end-diastolic velocity, resistive index, and volume flow (only for VA) were evaluated. The spinal segment, in which biomechanical aberrant movement was detected by palpation in the upper cervical spine, was manually manipulated in the MSM group. The same methodology was performed for the ISM group using an Activator V instrument (Activator Methods).
Results Intragroup analysis exhibited no statistically significant difference between the manual spinal manipulation (MSM) and instrumental spinal manipulation (ISM) groups in terms of of peak systolic velocity (PSV), end-diastolic velocity, resistive index of ipsilateral and contralateral ICA and VA, in addition to volume flow of both VAs preintervention and postintervention (P > .05). Within the intergroup analysis, there was a significant difference in ipsilateral ICA PSV (P = .031) (preintervention vs postintervention difference was –7.9 ± 17.2 cm/s [95% confidence interval, –17.4 to 1.6] in the ISM group and 8.7 ± 22.5 cm/s [95% confidence interval, –3.6 to 21.2]) in the MSM group (P < .05). Other parameters did not show any significant difference (P > .05).
Conclusion Manual and instrumental spinal manipulations applied to the upper cervical spine in participants with chronic NNP did not appear to alter blood flow parameters of the VAs and ICAs.
Key Indexing Terms Blood Flow Velocity; Chiropractic; Carotid Artery, Internal; Manipulation, Spinal; Vertebral Artery
From the FULL TEXT Article:
Introduction
History
Initial Examination
Initial Management
Discussion
Conclusions
Funding Sources and Conflicts of Interest
References
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